Tuesday, March 23, 2010

My Grandmother Was Right

Not long ago, a colleague of mine spilled an acid mixture on his clothes.

He knew what to do: He immediately removed his lab coat, pants, socks, and shoes. He washed off his legs and feet, even though he didn't think the acids got to his skin. He called the appropriate emergency number and closed the lab.

The accident occurred at a time when few people were around (think weekend, holiday, night), but my colleague knew I was working in my office in another building on campus, so he called me. I ran over to his lab, arriving after the campus police but before the paramedics.

Fortunately there were spare clothes in the lab, so he was dressed, albeit strangely, and sitting in a small office near the lab. I talked to the police and one of the paramedics in the corridor, giving them some of the information they needed for their forms.

I know that accidents can happen, even to experienced researchers like my colleague. Most of the safety training I have experienced, either from in-person workshops or via online modules, has seemed like a waste of time, but I think that the training serves the general (and important) purpose of reminding us that accidents can (and probably will) happen. Everyone in the lab needs to know what to do, and the right safety equipment must be accessible and available. Information, equipment, and awareness need to be updated on a regular basis.

The fact of the accident was not remarkable, and fortunately no one was hurt, but there are few aspects of the incident that were notable for me:

- The campus police were great. I had a bad experience with a rude and patronizing campus police officer a few years ago, so it was very nice to meet these very professional, polite, and competent police officers.

- The paramedics were not great. They were completely unprepared to deal with a situation like this. I am sure that they know well what to do when they encounter someone bleeding or broken, but they had no idea what to do in this case of a possible exposure to a dangerous chemical. My colleague was 90% sure that no acid got to his skin, but he wasn't 100% sure, as he explained to the paramedics. The paramedics didn't even seem to realize that time was important. My colleague didn't look injured, and they wasted valuable time making phone calls to other people who also had no idea what to do. They asked questions of my colleague and me, then relayed something completely different into the phone. One of them even started to tell an anecdote about something that happened to his father years ago. My colleague angrily cut him off, the paramedic told him to "calm down", and the campus police in the hall heard those words and became alert to a possible "situation". They thought that my colleague was refusing medical care, and the incident spiraled into an absurd series of misunderstandings. That was bizarre, but the most disturbing thing was that paramedics working within the call range of a major research university festooned with labs containing dangerous materials not only had no idea what to do, but didn't even seem to know how to get the information quickly. When told the best course of action by my colleague and me, they ignored us and made more phone calls.

What I learned:

- Be as self-sufficient as possible for emergency procedures. In recent years it has seemed to me that my university has been emphasizing a "just call 911" message in safety training rather than providing specific information and materials necessary to deal with an emergency on-site. Certainly it is important to call 911, but you can't rely on paramedics to know how to deal with all situations.

- Store colleagues' phone numbers in your phone. Even if they aren't people you would call to chat or text a cute picture of your cat, you may need to contact a colleague outside of working hours in an emergency situation. The phone numbers of colleagues who tend to work unusual hours and/or colleagues who would be able to help you in particular types of emergency situations could be useful some day. This doesn't just apply to lab accidents. If you work on campus outside of normal weekday working hours, you might want to have some colleagues' contact numbers stored in your phone.

- Keep spare clothes in the lab in case you have to get undressed unexpectedly in a semi-public setting -- advice that is related to the title of this post. My grandmother was thinking more of car accidents and events of that nature when she relayed the classic maternal advice about always wearing nice underwear, but, if you care about such things, it could also apply to working in a lab.

26 comments:

Kitty
said...

Wow, not only is it worrisome that paramedics working in close proximity to a university would not be knowledgeable about chemical hazards, but in this post-9/11 world, we have been led to believe that emergency personnel are now trained to handle these kinds of things.

Perhaps some sort of educational outreach to emergency responders that are likely to show up in these situations would be in order? For a number of years now Ohio Oil and Gas Energy Education Program has been training firefighters in eastern Ohio on how to deal with the sorts of emergencies that are unique to the oil and gas production business. It has been a roaring success, and has saved lives and prevented or reduced environmental disasters. A similar program would help Paramedics and Fire Fighters in your area to understand the unique dangers you face in your labs.

Can echo this experience I had as a grad student both for myself and one of my colleagues. Something I can share is that one should not use the word "bomb" (as in calorimeter) when discussing accidents with non-scientists. Entirely unproductive!

I agree about the self-sufficiency (not just personally, but in the lab). Frankly, in a university situation, I think that's the only real solution, because the hazards that can be present in a research lab are so complex and different from each other. It's not the same situation as the oil and gas model cited by Jim, 'cause the individual hazards encountered aren't likely to share much. And, in fact, such a scheme would over emphasize whatever the most recent hazard at the university was, rather than all the hazards that could occur, each with their own complicated treatment protocols.

I have personal experience with biohazards, for which time plays a different role. In the case you've described, time, right now, was of the essence. In our biohazards, the effects of exposure might be invisible for weeks, so there needs to be tracking and follow-up after the exposure.

So, I think an important part of the solution has to be toxin/hazard/biohazard training specific to the lab involved, documentation of the information at the local site of the hazard, and training for all emergency personnel on where that information might be found. And, yes, access to a phone number of a colleague who can understand and negotiate with all of those a really big deal.

I work in EH&S at a university. We had a chemical spill a few years back and the fire department's hazmat squads came out. We had the same experience -- that, while we had quite a few PhD scientists standing right next to them, they relied on the MSDS (which they took time to look up) for figuring out a response, rather than relying on the expertise available. We had an after-action meeting with the FD to discuss this.

Has your EH&S department gotten involved? If not, your colleague will want to contact them so they can work with the responders so this has a lower likelihood of happening again.

It's hard to ensure that every 911 responder can be trained for this kind of event. In my work, we are at risk of exposure to animal-born pathogens. We have exposure kits distributed throughout the work area. Included in this kit is a laminated sheet of instructions to be given to the health-care responders, detailing how to flush exposure sites, with what, for how long, what additional treatments may be indicated, and who to contact for further information. In several experiences of potential exposures, I have yet to meet a health care provider who knew what to do without referring to this instruction sheet, but every single one was very pleased to have it and they followed it competently.

Instead of focusing on the importance of self-sufficiency in an emergency situation, I am thinking about my own barely-there skivvies and the embarrassment of showing my bare ass to my lab mates. And PI. *shudders*

This is disturbing and it's not the first time that I've heard anecdotes like this about responses to lab accidents. In one case involving an acquaintance of mine and a lab fire, building access was a problem and the firefighters couldn't get in to put out the fire until the person injured by the fire was able to drag himself to the fire doors and open them because the fire dept. didn't have a key.

I agree the incident you described should be discussed with EH&S and I suspect EH&S will insist upon it. The other thing that I'd suggest is keeping a copies of not just the MSDS, but also the lab or university specific protocol for whatever you are doing. And when writing those protocols to think about emergency situations and the appropriate responses in advance. These protocols could then also be given to emergency responders who might put more faith in protocols than injured scientists.

I have a modicum of sympathy for the paramedics, since I used to interface with first responders (incl. the city hazmat team) in my volunteer work. At least one of these guys had a BS Chem and he still had to look up a lot of the chemicals he came into contact with. I think expecting hazmat people to keep up on everything they might possibly encounter is a bit like expecting a general practitioner MD to keep up on "specialty items".

I agree that self-sufficiency is the best policy. I also think my university's policy (call EH&S first, 911 second) is probably wise, since the EH&S people are probably more likely to know how to handle the nature of the emergency.

In terms of spare clothes: a good lab coat will cover a lot, enough to keep you modest. So having spare lab coats around, in a variety of sizes, would probably be a good idea. (I teach chem lab, so I'm thinking of general spills rather than just myself.)

The fact that the accident did not occur during a typical weekday work hour also complicated the response. The safety/hazard emergency response team couldn't even find the building; they are contracted to be on alert and respond to emergencies, but apparently are not required to be familiar with campus or facilities.

I've also worked within scrambling distance of a hospital, so even in cases of more serious injuries, we were able to get the person to an ER one way or another. But I don't know whether the "experts" there were any more help than your paramedics.

Our campus is big enough to have its own fire department, so here calling 911 is the correct first action. The dispatcher contacts the fire department and EH&S. The fire department knows every building and has good access. That said, there is no way that even EH&S can be current with the tens of thousands of different reagents on campus.

If your lab works with hazardous chemicals routinely, it is a very, very good idea to have something that the paramedics can find and read quickly to know what to do (or more importantly, what *not* to do) for the particular hazard.

My grandmother was thinking more of car accidents and events of that nature when she relayed the classic maternal advice about always wearing nice underwear, but, if you care about such things, it could also apply to working in a lab.

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It can get even more surreal: there was an electrical problem at a nuclear lab I once worked at that triggered a call to the fire department, and the campus rad safety people showed up in full gear - right down to the booties - while the firemen tromped around ignoring them.

At my previous institution, I inadvertently became responsible for a young woman who had passed out in a hallway. I called campus police (because I mistakenly thought there was an emergency medical team on campus). They sent me to 911, but also sent over a police officer. The guy did not have any EMT training and was more concerned about taking notes about what had happened. I sat there, trying to remember the little that had not escaped me from first aid training. Fortunately, the EMTs were great, once they got there. It makes me think I ought to go through first aid training again, and I don't even work in the proximity of dangerous chemicals.

I also have a friend who is a firefighter. He has told me he's absolutely terrified of ever being called to a fire in a cleanroom or lab. It's bad if the EMTs don't know how to handle it, but I really feel for anyone who may have to go in there if there is a fire or other serious emergency and shut it down.

This reminded me of the time I found out I was allergic to mosquitoes. I got bit on the back of my thigh. The welt was so huge, that it took up almost one side of my thigh. And let me tell you, that is huge! Anyway, I went to the doctor. She insisted that she take a look at it, even though there was an identical bite on my arm (which took up my whole arm). This also happened to be the day i wore lacey purple underwear. They were see through. And yes, I had to pull down my pants to show her my thigh, complete with the see-through purple underwear. Ahh, good times.

There have been some very well publicized and tragic laboratory accidents in recent years - safety training *CAN* be done in a meaningful way, it's just too bad that the main purpose is to cover the institution's "ass" rather than saving the researcher from harm.

Geomom, as and EH&S professional, I'd have to disagree with you. We are not trying to cover our butts -- we genuinely do want to keep the people in the lab safe. There *is* a component of keeping in compliance with various regulations (and there are a LOT) but we are trying to keep people from getting hurt.

That said, it's difficult when people choose not to follow rules that have been put in place to keep them safe. One of which, going back to this story, is that you should not be working alone.

Poison control is great! We called them when my husband spilled acid on his hands. They in turn told us to go to the hospital and they gave specific instructions to the emergency room before we even arrived. We were treated like VIPs upon reaching the emergency room. Though the triage nurses had very puzzled looks on their faces...my husband otherwise looked fine while the acid could have been dissolving his bones underneath the skin.

I agree that emergency and health types at research universities/hospitals must have a tough time keeping up with the huge diversity of things that could go wrong -- you can't have a formula in place that works for every situation.

In a reverse example, I once stuck myself with a sterile needle while handling not-at-all-diseased mice, so I washed it out and went to employee health just to be on the safe side and sort of dot my "i"s safety protocol-wise. Unfortunately I got shunted into the *hospital* employee needle-stick category instead of the research one and spent 2 hours being shuffled around between employee health and student health, then a 3rd hour reassuring a very concerned doctor that I really, truly, did not have HIV now (she had been told I was working with human patients.) It was a huge pain -- while I was stuck in the waiting room(s) and then the doctor's office my PI at the time had to finish *all* of my time-sensitive mouse handling.

But this was overall harmless and no-fault -- something like having emergency personnel who don't know where a *building* is? Or getting shuffled around cluelessly with strong *acid* on your hands? That's really scary.

About Me

I am a full professor in a physical sciences field at a large research university. I am married and have a teenaged daughter.
I have the greatest job in the world, but this will not stop me from noting some of the more puzzling and stressful aspects of my career as a science professor.
E-mail (can't promise to reply): femalescienceprofessor@gmail.com